Claim total
$641.13
base $93.83 · payer covered $326.50
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1982-09-18
- Stop
- 1982-09-18
The parties
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-79bd-440b692cbd90